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Five Tips To Manage IBS Without Eating Low FODMAP

I work with a lot of clients who have IBS, many of whom have struggled for years to self manage without success. In this blog, I want to discuss why elimination diets (specifically the low FODMAP diet, commonly used for IBS), is a way to alleviate symptoms, not manage a condition.

IBS stands for “Irritable Bowel Syndrome”, and it’s categorized as a “functional motility disorder,” with no known cause and no known cure.

Image republished from eMediHealth

To make matters worse both IBS symptoms and IBS symptom severity vary wildly from person to person. Despite IBS impacting between 25-45 million Americans, it presents itself differently from one individual to the next, ranging from mild inconvenience to severe debilitation.

It can be occasionally annoying or it can wind up controlling many aspects of someone’s emotional and mental wellbeing as well as their personal and professional life. Symptoms can be either intermittent or remain chronic. Some people have bloating some don’t. Some experience abdominal pain, others do not. You could struggle with constipation, diarrhea or cycling bouts of both. Other symptoms include nausea, cramping and abdominal pain, tenesmus, indigestion, gas, urgency, even anxiety, depression, and loss of appetite. IBS is often also accompanied by migraines, malaise, and chronic fatigue due to the persistent GI inflammation and/or malabsorption of nutrients from compromised gut health.

Despite there "technically" being a Rome criteria for diagnosing IBS I often feel most people get shoved into the IBS box simply because the medical community can't comfortably squeeze them into any other diagnosis. They’re told they have “Irritable Bowel Syndrome” and there’s nothing they can do except to eat a low fodmap diet and manage their stress. They are sent on their way, left on their own to try to piece together a coping strategy, which often involves guessing about OTC anti-diarrheal medications or laxatives; limiting their travel; waking up several hours before work in order to spend enough time in the bathroom; going entire days without eating so they can avoid triggering debilitating pain or an uncontrollable urgency to go; avoiding restaurants and socializing entirely; restricting themselves to a rigid diet of a dozen or so bland foods; and even changing careers to accommodate their unpredictable bathroom needs.

If this sounds awful to you, trust me it is. Survey data suggests that people with IBS miss an average of two workdays a month due to their condition. And, they score significantly lower on quality of life measures than people with diseases that are commonly considered more "serious" – including acid reflux, asthma and migraines.

The struggle is real.

Most IBS sufferers are desperate for relief so they jump into doing the fodmap diet, which has been well researched by Monash University. This diet has been shown to help improve the symptoms of IBS. But it is in fact, “second-line therapy”, which means there are some strategies that are less difficult that you can try first before you move onto a professional or dietitian-supervised low FODMAP diet.

Because ultimately IBS is not an illness that flares up only because of what you do or don’t eat.

Researchers have identified multiple physiological differences between people with IBS and their healthy peers, including: differences in how the brain and gut communicate to signal pain; differences in the types of microorganisms living in their guts; and differences in the way the gut's lining and immune cells interact with various stimuli. Going on an elimination diet does nothing to address these factors.

I absolutely acknowledge that certain IBS symptoms may relate to or become exacerbated by certain foods. However, I don’t consider it “safe”or even the first best course of action to automatically jump on a hyper restrictive diet. Especially not when there are some high yield lifestyle tweaks you can try first.

  1. Ditch carbonated beverages and don’t drink through a straw. I lump these two together because they both cause the same issue, they cause you to swallow excess air which can increase the amount of gas trapped in your bowel. It sounds simple but it can make a world of difference when it comes to alleviating abdominal pain and bloating.

  2. Slow down when you eat. When was the last time you took a full 20-30 minutes to eat a meal? In our society it’s become commonplace to treat eating like an inconvenience instead of regarding as the act of crucial self nourishment that it is. Far too many people wolf down their food at the speed of light and are barely chewing as a result. Slowing down, sitting down at an actual table away from the TV, screens and distractions, and thoroughly chewing your food can help alleviate some of the symptoms of IBS that you may be experiencing.

  3. Nix gum, mints and other products with sugar alcohols. Sugar alcohols such as sorbitol create excess gas and in high amounts may even have a laxative effect. Sugar alcohols are polyols, a group of reduced-calorie carbs that provide the taste and texture of sugar with less calories. Some common ones are Xylitol, Erythritol, Maltitol and Lactitol. But sugar alcohols can lead to stomach issues because they are not very well absorbed/digested by the body. Some of the sugar alcohols will pass into the bloodstream, but the majority will travel on through the intestines unabsorbed. Once in the intestinal tract, sugar alcohols link up with bacteria that ferment it, releasing gas, which leads to bloating, cramps, pain, and/or diarrhea.

  4. Calm down. Stress does not cause IBS but there is a strong correlation between someone’s stress response and a flare up of IBS symptoms. The gut and brain are inextricably connected via the gut-brain axis, so if your mind is uneasy, anxious or you’re experiencing symptoms of anxiety or depression – this can impact your bowel movements, transit time, and your physical (or mental) perception of pain. Deep breathing and relaxation techniques can be effective strategies to help calm down the vagus nerve that connects the brain to the nerve endings in the gut. Try taking four to five deep inhales and exhales. Breathe in for a count of five, and slowly breathe out for a count of five. Pause. Then repeat. You can also try gut-directed yoga poses which has been shown to be just as effective as the low FODMAP diet in improving the symptoms of IBS.

  5. Caffeine/ Alcohol/ Fat and Fiber. In my opinion these are some of the least invasive dietary components you can think about when it comes to managing IBS. FAT: Diets very high in fat can be an irritant to the gut, stimulating more frequent bowel motions, and loose or poorly formed stool. If your stool is oily or floats, likely you are having issues digesting fat. FIBER: If you struggle with constipation you may want to examine your fiber intake, paying particular attention to getting enough insoluble fiber. ALCOHOL: Alcohol causes problems even in a healthy persons gut, let alone someone with IBS. Researchers have found alcohol decreases absorption and movement of carbs which can increase their side effects like bloating, gas, and stomach pain. Alcohol also diverts energy away from digestion as your body prioritizes it’s removal. CAFFEINE: Caffeine is touchy. I know you may be addicted to your XL coffee but the truth is caffeine irritates the gut lining, and if you’re predisposed to diarrhea you may find it worsens your symptoms. Try experimenting with reducing your caffeine intake to see if it helps. If you like the taste of coffee try switching to decaf. Better yet trade coffee for some lemon ginger or peppermint tea. Peppermint tea can help calm bloating and gas and lemon ginger tea alleviates stomach pain abs indigestion.

I do want to be clear- in no way am I opposed to elimination diet if one is needed. I’ve done elimination diets myself and I’ve used them frequently with clients. However it's important to remember they don't need to be the first response. Sometimes simple hacks like these are all you need to manage your irritable stomach and ease your digestive symptoms.

If you do feel an elimination diet is warranted make sure you work under the supervision of a qualified professional. Elimination diets are meant to be temporary, not permanent. In fact, by remaining on a strict elimination for too long you could unknowingly be laying out the welcome mat for other health issues.

Enlisting the help of someone who can help you properly execute an elimination diet and then also help you reintroduce foods appropriately is crucial.

Lastly, IBS is not a single disease with a single cause. We now know that it’s a whole host of diagnoseable health issues, which is why when a client comes to me with IBS, together, we look further for complete healing. While the exact root cause, or combination of causes, is unique to each person, some common root causes are SIBO, dysbiosis,defects in intestinal barrier function (leaky gut), gut infections (parasites, fungi, bacteria like h pylori) and prior use of antibiotics (often used to kill another gut infection) is also a very common cause of gut infections. While antibiotics can sometimes be effective at killing the primary bacterial infection, by destroying all the good bacteria at the same time, they also create an environment for opportunistic pathogens and overgrowths to proliferate and cause long-term chronic conditions. Lastly, sometimes it's food sensitivities. Personally I believe that food intolerances are themselves, often a symptom of IBS not a cause. While food triggers can definitely make IBS worse, generally they are a sign of a deeper root cause. And when that underlying root cause is identified and healed, avoiding foods forever usually isn't necessary!

I really hope this post helps you understand why you need to keep searching for the root cause of your IBS. Your doctor has hopefully ruled out all the nasty and life-threatening stuff, so its time to get to the functional root cause that is completely healable.

Healing the gut is a journey. If you are ready to begin yours, please check out my coaching here to learn more about how I work online with clients who have IBS symptoms and other GI conditions.

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